Hearing Screening Online Training Program
Preparing the child for the procedure:
- The screener should call the child by his/her name and inform the child that the screener is going to check the child’s hearing.
- Have the child remove glasses, ribbons, barrettes, combs, or large earrings if they obstruct a good seal on the headphones.
- Push the child’s hair behind his/her ears (this is a good time to quickly inspect the external ear).
- Check for hearing aids, cotton in ears, or drainage.
- If tenderness, signs of drainage, or foul odor is present, do not proceed with the audiometric screening; the child should be evaluated by a medical provider (For complete information on documentation, see C&TC Documentation section). It is okay to proceed with the test if earwax is present.
Play audiometry technique:
Place the headphones on the table facing the child with the audiometer set at 2000 Hz and maximum decibel level to ensure the tone is audible.
The screener holds a toy near his or her ear, assumes a “listening” attitude, and presents the tone. The screener then indicates through his or her facial expression that the sound was heard and drops the toy in a pail. This may be repeated as often as necessary until the child shows interest.
The screener offers the toy to the child and places his or her hand on the child’s to guide the child’s first responses. The screener should encourage the child to wait until the sound is heard. When the child appears ready, present the sound; the tone should be presented for at least one full second but should not exceed two seconds.
Guide the child’s hand to put the toy in the container. Start by physically moving the hand, then slowly decreasing assistance to a nudge until the child responds on his/her own. The child should drop the toy into the pail each time he or she hears the sound.
When the child is ready to play the game, set the audiometer to 40 dB, set the frequency to 1000 Hz, and set the earphones on the child.
Putting the headphones on the child:
- Place the red earphone on the child’s right ear and the blue earphone on the left ear.
- Line up the opening of the earphone with the opening of the child’s ear canal.
- Adjust the headband so it is seated on top of the child’s head.
If the child does not accept the headset, the screener should try putting it on the child for only one or two seconds, remove, and praise the child. The time with the headset on should be slowly increased.
Look for a waiting posture where the child indicates readiness to listen and an ability to wait until the tone is presented.
Once the child understands the play audiometry technique, you may continue using the same audiometric procedure as described in the standard pure tone screening section.
Note: If the child cannot be tested at this point, STOP and document “Could Not Test (CNT)” and re-screen the child in two to three weeks. For complete information on documentation, see C&TC Documentation section.
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